HomeMy WebLinkAboutMortgage_Ferguson�`,«: "3 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Count 7ownship Year
�J [ 51ate Fortn 43709 (R6/ 5-06) . .
� Resvibetl by Department of Local Gwemmen� Finance
INSTRUCTIONS � O C T O���q�
To be filed in person or by mail with the County Audito� of the county whe�e the property is located.
Filing Dafes: 1J Rea/ Property: Dunng fhe 12 monfhs before ,lune 11 0/ the year the deduction is to be e���jj'e.
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 o(the year(h�AE�,��to 6e elfective.
See reverse side for addifional instrucfions and qualifications. GIBSON C UNTY AUDITOR
(owner or crontract
Taxing
v
on
Key number /
6- � y-o 7-300 , v od. 3i 8-0
Record number � O O �
Page number � G O
Assessed value of real property as of Mortgage / Contrad indebtedness unpaid as of I Is the applipnt the sole legal or equitable
March 1, current year March 1, curtent year owneR ❑ Yes ❑ No
��.7 % �5• � �
If no, what is his ! her exad share ot interest7
name on record is different than that
of mortgagee Or
indicate below:
If owned with someone other than spouse, indicale with whom.
- v
of mortgagee or contred seller (number and street, city, state,
assignee or other owner or holder of mortgage
of assipnee (number
Does applicaM awn property in any
county in Indiana?
sfate, ZlPCOde)
If yes, what county?
Deduction approved in the amount of:
20 _� 20 �,_ 20
P P
Signature
❑ Real PropeAy ❑ Mobile Horne (IC Cr1.1-�
`O$
\�P.:uu•^i;�.11DD�
Dra��'er 1 `
VYhat T, CaC \ """ �,ted on
�cl ! / I.�' %�5❑ No
��''�...•l
COUNTY AUDITOR
20
County Auditor
20
20
�
certify.under lhe penalty of perjury lhat the above and foregoing infortnation is true and corred and that the applicants was / were
lent of Iridiana and owner of the aforemenlioned property on March 1, 20
.� �11�.
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-72-.07
iliqnt � (Address of authorized person
,e ad 5'I � �' -�C•f�